Korean Circ J.  2007 Apr;37(4):154-160. 10.4070/kcj.2007.37.4.154.

Comparison of Efficacy and Safety after Administering High Potency Statin to High Risk Patients: Rosuvastatin 10 mg versus Atorvastatin 20 mg

• Yun KH
• Park HY
• Choi JH
• Song MJ
• Park EM
• Kim YK
• Rhee SJ
• Lee EM
• Lee J
• Yoo NJ
• Kim NH
• Oh SK
• Jeong JW

• KMID: 2227072
• DOI: http://doi.org/10.4070/kcj.2007.37.4.154

Abstract

BACKGROUND AND OBJECTIVES: Although the rate of prescribing hydroxylmethyglutaryl-CoA reductase inhibitors (statin) has recently increased, there is a large treatment gap between the guidelines and actual clinical practice. We studied the effect of high potency statin on the percentage of patients who achieve the target low density lipoprotein (LDL) cholesterol level, and we determined the changes of lipid profiles with using 10 mg of rosuvastatin and 20 mg of atorvastatin.
MATERIALS AND METHODS
222 consecutive patients with acute coronary syndrome or acute ischemic stroke were randomly assigned to either the group treated with rosuvastatin 10 mg (Group I) or atorvastatin 20 mg (Group II). We compared the percentage of patients who achieved the target LDL cholesterol level, and the percent change of the serum lipid profile from baseline to the 40th week between the two groups.
RESULTS
117 (52.7%) patients completed this study. When the target LDL cholesterol level was <100 mg/dL, there was no significant difference in the target attainment rate between the two groups (86.7% vs. 77.2%; respectively, p=0.182). When the target LDL cholesterol level was <70 mg/dL, 48.3% of Group I and 29.8% of Group II reached the goal (p=0.040). The LDL cholesterol level was reduced by 46.8% in Group I (p<0.001), and by 40.1% in Group II (p<0.001). However, the final level showed a trend to be lower in the rosuvastatin group (p=0.077). There were no serious side effects in both groups. The study drug was discontinued due to adverse events in 2 patients (2.6%) of Group I, and in 3 patients (3.8%) of Group II (p=0.523).
CONCLUSION
This study showed that the reduction of LDL cholesterol was not statistically different between rosuvastatin 10 mg and atorvastatin 20 mg. However, fewer than half of the patients achieved the goal in both groups despite of high potency statin therapy. This suggests that more aggressive statin therapy is preferred for high risk patients.

Keyword

Hydroxylmethyglutaryl-CoA reductase inhibitors; Cholesterol; Guideline

MeSH Terms

Acute Coronary Syndrome
Cholesterol
Cholesterol, LDL
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors*
Lipoproteins
Oxidoreductases
Stroke
Atorvastatin Calcium
Rosuvastatin Calcium
Cholesterol
Cholesterol, LDL
Lipoproteins
Oxidoreductases

Figure

• 

  Fig. 1 The flow chart of the study.

• 

  Fig. 2 Goal attainment rate. When the target LDL cholesterol level was <100 mg/dL, there was no significant difference in the target attainment rate between the two groups (86.7% vs. 77.2%; respectively, p=0.182). When the target LDL cholesterol level was <70 mg/dL, 48.3% of Group I and 29.8% of Group II reached the goal (p=0.040). LDL: low density lipoprotein

• 

  Fig. 3 Changes of the lipid profiles before and after high potency statin therapy. The total cholesterol level was reduced by 27.8% in the rosuvastatin 10 mg group, and by 22.3% in the atorvastatin 20 mg group (p<0.001), the LDL cholesterol level was reduced by 46.8% in the rosuvastatin 10 mg group, and by 40.1% in the atorvastatin 20 mg group (p<0.001). However, the final level showed a trend to be lower in the rosuvastatin group (p=0.026 in total cholesterol, p=0.077 in LDL cholesterol). *: p<0.05, **: p<0.01. HDL: high density lipoprotein, LDL: low density lipoprotein.

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